Girl with Tessier Facial Cleft Undergoes 3D-Printing Surgery to Reconstruct Face

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Dr. Meara and his colleagues’ motto is “When the going feels impossible, the impossible is challenged with innovation”.

In order to help the little Violet Pietrok, they came up with an innovative idea of using 3D- printing in the medical world in case such as Violet’s.

Alicia Pietrok from Oregon gave birth to two twins, Cora and Violet, on February 12, 2013. Unfortunately, Violet was born with Tessier facial cleft, a rare cranial condition, although she was born just two minutes apart from her sister. Tessier facial cleft means that the structure of the skull and facial tissues didn’t come together properly. In other words, her nasal cavity didn’t have proper cartilage, and her eyes were spread apart.

Alicia and her husband Matt went to Boston’s Children’s Hospital after doing a lot of research about how to improve the condition of their daughter. They talked with the vice-chair of neurosurgery, John Meara, MD, and the director of SIMPeds, Peter Weinstock, MD.

Alicia knew her daughter’s condition is so rare that was an uncharted territory seen as a case study for cranial facial surgery by medical students. But, the doctors she and her husband went to, had similar cases 4 times before Violet in the past couple of years.

After doing some MRI scans, Dr. Weinstock and Dr. Meara printed a 3D- model of the little girl’s skull, using the specification and data obtained by them. Layers of resin were laid down to actually restructure Violet’s precise cranial features together with acrylic colors to locate exact spots. In this way, the doctors made a simulated hard copy which helped them understand the condition of Violet, without the interference of skin and tissue covering the area.

Then, the doctors tried to make different cuts on the model in the lab, to help them foresee potential obstacles, as well as if bone structures will make contact if they bring Violet’s eyes together. They practiced on the models a lot of times until they discovered the perfect technique. Unlike the past cases, Dr. Meara says 3D-printing made it possible for them to dismantle the skull like never before, since they were able to see areas in the skull.

They used the 3D-models as map or blueprint to guide them in the process of bringing Violet’s eyes together, as well as to press the uneven parts of Violet’s skull back to the proper position, with a millimeter precision. After their long practices and preparations, the doctors informed Violet’s parents about her surgery. Alicia was concerned if the surgery will compromise the organs and tissues’ functions in her daughter’s face, like the optical nerve responsible for the vision. But, the doctors reassured that everything will be fine.

The first phase of the surgery was moving Violet’s eyes closer together, and closing the forehead gap. The surgery lasted 10 long hours, but Dr. Meara approached to the parents smiling, saying the surgery was successful. The girl remained in Boston for six weeks to recover. Dr. Meara frequently calls the parents by phone or Skype to give them advice how to care for their daughter’s surgical wounds and stitches.

The first phase ended when her skull healed and her cranial tissues adjusted to the new structure. The second one was projected for 2016 and involves adjusting the nasal tissues. They try to repair Violet’s face completely by the time she goes to first grade. 3D-printing has shown once again that it can be very helpful in making medical procedures more accurate and quicker, thus improving the face of surgery.[content_container max_width=’500′ align=’center’][/content_container]
Via Cure Joy | Medical Daily | Boston Magazine

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